Background and Goal of Study:
Graft reperfusion, a phase in kidney transplantation, may show rapid
changes in hemodynamic parameters. The purpose of this study is to be
able to detect the hemodynamic and metabolic alterations between the
two solutions with EKG variations that may occur following the kidney
graft reperfusion.
Materials and Methods:
While Group 1 (n=40) uses university of wisconsin solution (Servator
B SALF (S.A.L.F S.p.A., Cenate Sotto, Italy) solution), Group 2
(n=40) uses Histidine-tryptophan-ketoglutarate solution (Bretschneider
modificata (Galenica Senede, Siena, Italy) solution). Living kidney
transplantation cases that do not have any cardiac complaints were
included in the study. Demographic data such as age, sex, ASA as well
as preoperative, perfusion and postoperative EKGs were taken at the
same time with the blood gases. Hot and cold ischemia times of the
kidney graft were recorded according to the amounts of graft wash
solution used.
Results and Discussion:
No differences were observed in terms of demographic data, operation
periods, hot and cold ischemia times, blood gas analyses and
electrolytic changes. In Group 1, 34 patients were observed to have
cardiac problems (Bradycardia: 19, Asystole: 8, Inotropic treatment: 7
patients). The incidence of bradycardia, asystole and inotrope
adjustments between groups were shown at table 1. No cardiac changes
were observed in Group 2. Comparing Group 1 and Group 2, while
preoperative corrected QT interval (cQT) was not found to be different
(p=0,981), perfusion cQT (p=0,01) and postoperative cQT (p=0,014)
were found to be significantly different. In Group 1, perfusion cQT
(p=0,001) and postoperative cQT (p=0,001) were observed to differ
from preoperative cQT. There were no differences between perfusion
cQT and postoperative cQT (p=0,575). In Group 2, perfusion cQT
(p=0,019) and postoperative cQT (p=0,026) were observed to differ
from preoperative cQT. There were no differences between perfusion
cQT and postoperative cQT (p=0,825). (Table 2).
Conclusion(s):
Although hemodynamic and metabolic parameters are at normal levels
during kidney transplantation, particularly in graft reperfusion stage,
the kidney transplantation bears a risk in terms of disorders in
ventricular repolarization period. Evaluation of QT interval can be an
essential parameter in order to take required precautions and foresee
complications. Whilst preoperative EKG of the cases provides
warning, electrolyte levels must also be taken into consideration.

05 / Electrocardiogram differences in reperfusion phase of kidney transplantations from living donors